NHS Speech Therapy

We had a (failed o education tribunal this week - I am in Scotland so the procedures are a bit different. I don't want to bog everyone down in the details but the NHS speech therapist told the tribunal that the NHS has no limitations or restraints whatsoever on its budgets and that all decisions are made on clinical grounds. She only met our son briefly at his school to write a discharge report but said her expertise and work experience enabled her to know that he could not benefit from any from speech therapy (though she did concede his verbal vocabulary could be increased so not sure what she meant by that). She was questioned about this 'limitless budget' by our lawyer but she was adamant it is the case that there are no financial limits whatsoever. She said that his disability/autism would prevent him from benefitting from speech therapy. We are considering an appeal but does anyone have any thoughts on this point ?

Well - if only. The issue at the moment is to limit numbers to what we can manage - i have six local 'mums' on board and don't think we can go beyond that as thinking there will be 2 therapists for a 2 hour session so we will be giving both 1-1 and group based language games (where appropriate) . So all I need is a church hall and a small amount of seed corn money - I wonder if I could go on Dragons' Den ?

Willow - you are incredible to be starting an after-school SALT club. I would sigm up in a sht in my area! If you also put something about socialising (mums and kids) in the flyer, I reckon you have a national winner. You could be the new Stagecoach!

Yes - thisis feeling similar and need to try to remind myself that it's supposed to be David that wins not Goliath. On the positive side, I am pushing on with my own initiative which is to start an after school SALT club for autistic children. I've had some lucky breaks and so it may happen sooner than I thought !

Willow - our GP said he was appalled by the long wait, and the total lack of anything available to DS1 - he said that perhaps I ought to complain to our local MP. I have lost the will to live at the moment, due to ongoing battle with HT and everyone / everything really.

Yes - on the day - just digesting it all now as was not expected. Even LEA lawyer, who have to admit is very honest and courteous, was bit amazed he got a decision in his client's favour. I think judicial review may be the way to go as there were many other procedural flaws such as convenor(chair) not being aware of how to do a tribunal and our lawyer having to explain it to her - still got to laugh it's only our children at stake...

Handywoman - it is because the NHS doesn't know what to do with children with ASD so they say there is nothing that can be done, when they mean there is nothing I can do.

This is particularly complicated with Asperger's as the service never gets any experience supporting them and hasn't clue how to support verbal communication deficits let alone non verbal communication.

But in the case of children with problems speaking, you have to ask what the fooking hell are they doing as a service if they can't treat kids who have trouble talking?

what is all this about ASD kids not being able to benefit from SaLT? i'm sorry it makes me really cross. I think it's an outrage. Language issues are often at the heart of ASD and maximising language ability means maximising the ability to generalise, learn, understand the world, and function socially. I just donotgetit. I'm afraid what I hear from this SaLT is "I am a bit crap, I can't do anything with this boy". And if she really thinks the NHS is a bottomless pit then she has a very poor awareness of her employer and how it works. I'm sorry, this post is no practical help whatsoever. I am just so angered on so many levels to read this, OP. Honking loudly for you.

I don't know about Scottish law, but in E&W, the NHS is subject to the rationing principles of the NHS Act which means it is obliged to provide a service based on clinical need.

The problem usually arises when therapists assess clinical need in the light of (a) what they are able to do for the child and not what the NHS as a whole service could do, i.e. they look at the limitations of their skills and don't consider what others, more experienced could provide and (b) they look at a child against the whole of their case load. This means they will always be able to find more 'needy' children.

Point (a) is clearly significant here as what this therapist is basically saying is that she wouldn't know what to do to help your son. You need to show that others do know and it is the limits of her knowledge and experience which lead her to conclude this and not the innate difficulty of teaching a child like your son.

It is important to remember as well that education law is not based on clinical need principle but on evidence of educational need and is not subject to the same rationing principles or any comparative analysis between the child and a peer group or what a service 'usually offers' to a child like this.

I assume the Scottish SEN framework is the same.

Did you have your own S&LT? You will need one to establish exactly what his needs are and how they constitute a SEN and how they can be met by provision. The S&LT then needs to outline what this provision should be.

Willow I am also in Scotland, and DS1 has waited over 2 years for speech therapy. News report last week said that the 18 week maximum wait was being fiddled by NHS trusts, who make treatments "unavailable", therefore cancelling out waiting lists IYSWIM.

What is doubly frustrating is that if the SALT profession would just open their minds to a couple of basic ABA techniques, they would find they could achieve so much more! I wrote an article on this once for he SALT magazine, Bulletin, but they refused to publish.

ds can talk though only at a limited 2-3 word level and has big one word vocab. Even NHS SALT told tribunal that his ' verbal vocabulary could be increased' by speech therapy but went to qualify this with unsubstantiated nonsense about it not being functional language and guess what, not generalising. This is simply not true and how on earth would she know anyway having met him only once ! My feeling is that I want to take some form of action under Disability Discrimination as she was so adamant that there was financial reason for refusing him a service